Immune System
Immune System Function Questionnaire
The immune system is related to many areas of the body including digestion, lungs, skin and the liver. For example up to 70% of immunity is related to digestive function which in turn is related to the adrenal gland. Proper assessment and a treatment plan are important to optimize one’s health.
Underlying conditions maybe allergies, sensitivities, hormone imbalance or digestive weakness.
This subjective questionnaire will give your health care practitioner a quick summary of symptoms or signs that may be related to immune system function. It is not a substitute for professional medical advice from your health care provider.
1. ___ Are you susceptible to colds and flus?
2. ___ Do you frequently have itchy eyes or nowe?
3. ___ Do you cough often?
4. ___ Do you have a chronic runny or stuffy nose?
5. ___ Do you frequently experience an itchy mouth or throat?
6. ___ Do you frequently have cold sores or fever blisters?
7. ___ Are you sensitive to chemicals?
8. ___ Do you have frequent skin rashes?
9. ___ Do you have reactions to certain foods?
10. ___ Do you experience fatigue not helped by rest?
11. ___ Do you feel you should eat a healthier diet?
12. ___ Do you get at least 7 hours of sleep nightly and relax daily?
13. ___ Do you have a very stressful lifestyle? ie busy , worry alot, have trouble sleeping?
If you have 2 or more Y answers you may be at risk for immune conditions.
It is recommended to consult with your health care professional team.
